Georgakopoulou VE, Damaskos C, Sklapani P, Trakas N, Gkoufa A. Pleural involvement in cryptococcal infection. World J Clin Cases 2022; 10(16): 5510-5514 [PMID: 35812673 DOI: 10.12998/wjcc.v10.i16.5510]
Corresponding Author of This Article
Vasiliki E Georgakopoulou, MD, MSc, Doctor, Department of Infectious Diseases, Laiko General Hospital, 17 Agiou Thoma Street, Athens 11527, Greece. vaso_georgakopoulou@hotmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Vasiliki E Georgakopoulou, Christos Damaskos, Pagona Sklapani, Nikolaos Trakas, Aikaterini Gkoufa, Department of Infectious Diseases, Laiko General Hospital, Athens 11527, Greece
Author contributions: Damaskos C and Sklapani P designed research; Trakas N performed research; Georgakopoulou VE wrote the letter; Gkoufa A revised the letter.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vasiliki E Georgakopoulou, MD, MSc, Doctor, Department of Infectious Diseases, Laiko General Hospital, 17 Agiou Thoma Street, Athens 11527, Greece. vaso_georgakopoulou@hotmail.com
Received: January 21, 2022 Peer-review started: January 21, 2022 First decision: March 23, 2022 Revised: March 30, 2022 Accepted: April 30, 2022 Article in press: April 30, 2022 Published online: June 6, 2022
Abstract
Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones. Pleural involvement in cryptococcal infections can manifest with or without pleural effusion. The presence of Cryptococcus spp. in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection, which is commonly determined by pleural biopsy, fluid culture, and/or detection of cryptococcal antigen in the pleura or pleural fluid.
Core Tip: The importance of pleural involvement in cryptococcal infections is often overlooked. When biopsy results are inconclusive, further testing for invasive granulomatous infections, such as pulmonary cryptococcosis, should be done. When indicated, a sensitive cryptococcal antigen assay and fungal culture should be used to evaluate pleural effusion specimens. Even if the cryptococcal antigen test is negative, clinicians should investigate pleural cryptococcosis in cases of pleural nodules without pleural effusion, especially in the context of immunosuppression.
